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Drugs That Cause Dilated Pupils

drugs that dilate pupils

Drugs That Cause Dilated Pupils and Why It Happens

Most people are usually familiar with what dilated pupils are, and chances are you are as well! When you were younger you might have shone a flashlight into one of your eyes and watched your pupil shrink before moving the light away and watching it dilate again.

You might also recall your most recent visit to the eye doctor where your doctor put some special eye drops in your eyes to dilate your pupils. By opening up your pupils, eye doctors can take a better look at your eyes and examine them more closely for any abnormalities.

In regular lighting your eyes also adjust. When you walk into a dark room after being in a light-filled room, it can be difficult to see. However, when you give your eyes time to adjust, the pupils dilate (expand) to take in more light and you can see.

Similarly, when you walk out of a dark theater into a sunny parking lot, you might feel blinded by too much light. That’s because when you’re sitting in a dark theater, your pupils dilate, but the sudden move from a dark theater to a sunny area is faster than your eyes adjust. After a few moments in the parking lot, your eyes soon adjust and you don’t feel as blinded anymore.

These situations are ones that a lot of us are familiar with, but what about other instances that cause dilated pupils?

Did you know that certain drugs can cause dilated pupils? In today’s blog, we’ll explore why pupils dilate, what substances cause dilated pupils, potential risk factors of dilated pupils, and managing dilated pupils.

What Are Pupils and Why Do They Dilate?

Pupils are the black circle in the center of your eye. Pupils shrink (constrict) and grow (dilate) in response to varying light levels. Their function is to let light in and direct that light to your retina, which are the nerves at the back of your eye, allowing you to see.

Pupils constrict and dilate through muscles in your eye that are located in the iris. The iris is the colored ring of your eye. The iris is what people will look at to determine what color eyes you have. For example, people with a blue iris have blue eyes and people with a brown iris have brown eyes. Each iris contains the muscles necessary to manipulate the pupils.

Under normal conditions, pupils are usually the same size. According to healthline, a normal pupil measures approximately 4 to 8 millimeters when fully dilated and 2 to 4 millimeters when constricted.

A Variety of Reasons for Pupil Changes

There are a variety of reasons why pupils dilate or appear to be different sizes that go beyond changes in light levels. These range from everyday occurrences to mental conditions and even substance use.

  • Distance of objects you’re looking at
    • Pupils also naturally dilate or constrict based on distance in addition to light levels. Focusing your gaze on something closer to you will cause your pupils to constrict. Casting your gaze towards something farther away will cause your pupils to grow.
  • Concussions
    • You’ve probably heard of concussions before. Maybe you’ve even experienced one before. They’re especially discussed a lot in the realm of contact sports. A concussion is a brain injury that usually results when a hard impact or blow to the head causes the brain to smack into the skull. This can result in a person’s pupils becoming asymmetrical, with one pupil noticeably larger or smaller than the other.
  • Anisocoria
    • Anisocoria is the name used to describe the condition in which pupils happen to be different sizes that aren’t a result of injury to the head. According to the American Academy of Ophthalmology, 1 in 5 people naturally have anisocoria. Many of these people have absolutely no problems that stem from their pupils being two different sizes.
    • However, we should caution that sometimes, anisocoria can sometimes be a sign that there is a more serious eye problem. See an eye doctor if you are concerned about this condition. The American Academy of Ophthalmology explains that people with anisocoria could have
      • A nervous system problem
      • A history of eye damage
      • A risk of having a stroke
      • An infection
      • Adie’s tonic pupil (a condition in which one pupil doesn’t respond to light as well as the other)
  • Cluster headache
    • A cluster headache refers to a specific kind of very intense headache that affects one very focal point of the face. Typically, cluster headaches take place behind the eye and can be very painful. The name “cluster headache” refers to the multiple headaches that occur within an episode. Some people may experience up to eight headaches in one day. The pupil can shrink throughout the duration of these headaches.
  • Iritis
    • Iritis is a condition in which the iris, the colored ring of your eye, experiences some inflammation. Inflammation can occur for a variety of reasons including infection, trauma, and autoimmune diseases. Because the iris contains the muscles necessary to control the pupil, problems with the iris in cases like iritis can cause abnormally sized pupils.
  • Horner’s syndrome
    • Horner’s syndrome is a condition in which an individual has a disrupted nerve pathway or a nerve pathway that has been damaged. This nerve pathway runs from the brain to the face and eye. Injury to that nerve pathway can cause pupils to constrict.
  • Your emotions
    • It might sound a bit strange, but your emotions can affect how your pupils look! The International Journal of Human-Computer Studies published a 2003 study that found the dilation of pupils as a reaction to emotional stimuli such as laughter or a baby crying.
  • Illicit substance use
    • Illicit substance use is one of the prominent side effects from a variety of different drugs. Substance use can both constrict and dilate pupils depending on the substance. We’ll take a look at which drugs do what in our next section.
  • Prescription medication
    • Although illicit substances get most of the attention when it comes to pupil dilation and constriction, prescription medication or medication that you can get over the counter can also affect the iris’ muscles. The next section will cover which prescription medications can affect pupil dilation or constriction in more detail.

Illicit Substances and Prescription Drugs That Affect Your Pupils

A variety of drugs have the power to affect pupil size because drug interactions in the body often affect neurotransmitters in your brain. Neurotransmitters are chemical messengers in your body. The interactions and messages between neurotransmitters are key in operating your body’s central nervous system. The interactions between neurotransmitters help control your bodily functions and enact proper functions.

Many drugs, due to their chemical makeup and the chemical reactions they cause in your body, can cause neurotransmitters to be affected. Because neurotransmitters play a role in your pupil size, a variety of medications and illicit substances affects the appearance of your pupils.

Prescription and over-the-counter drugs that can affect pupil size include

  • Anticholinergics
    • Blocks acetylcholine, a compound in the central nervous system that functions as a neurotransmitter
  • Anticonvulsants
    • These medications are often prescribed to treat epilepsy and seizures. In order to limit the severity or frequency of epilepsy and seizures, anticonvulsants alter neurotransmitter activity and nerve impulses.
  • Antidepressants
    • Many antidepressant medications target serotonin and norepinephrine. These two are chemical messengers that control many bodily functions.
  • Antihistamines
    • Antihistamines are often used to help relieve the symptoms of a variety of allergies. They work by blocking the immune system’s response to allergy symptoms like sneezing or an itchy or closing throat. For example, Benadryl® is a well-known antihistamine.
  • Benzodiazepines
    • Although they are often associated with substance misuse, benzos can also be legally prescribed. There are, however, some unfortunate cases in which individuals become hooked on benzos and begin to misuse them. Benzos impact a particular neurotransmitter that relaxes muscles.
  • Decongestants
    • Decongestants typically shrink blood vessels in order to address swelling and inflammation.
  • Dopamine precursors
    • Dopamine precursors boost levels of the neurotransmitter dopamine in the body. Since dopamine is responsible for many bodily functions, pupils can also be affected.
  • Mydriatics
    • Mydriatics are also known as the eye drops that dilate your eyes. When you go to the eye doctor or need to undergo a particular eye surgery, these eye drops are used to take a better look in your eyes.
  • Stimulants
    • Prescription stimulants are used in the treatment of attention-deficit/hyperactivity disorder (ADHD). Stimulants are well known for causing pupils to dilate.
  • Selective serotonin reuptake inhibitors (SSRIs)
    • SSRIs are often used in treatment for depression since they boost serotonin. Low levels of serotonin can cause depression, anxiety, and sleep trouble.

Commonly misused drugs that dilate pupils include:

  • Amphetamines
  • Bath salts
  • Benzodiazepines
  • Cocaine (including crack cocaine)
  • Crystal methamphetamine
  • Ecstasy
  • Ketamine
  • LSD
  • MDMA
  • Mescaline

Commonly misused drugs that constrict pupils include:

  • Oxycodone
  • Fentanyl
  • Heroin

Are There Permanent Side Effects To Dilated or Constricted Pupils?

When you experience dilated or constricted pupils as a result of substance use, you might wonder if your pupils could permanently remain in such a state. The good news is that pupils usually return to a normal functioning state after the side effects of drug use have worn off.

You should note, however, that some drugs can cause pupil dilation during the withdrawal period. Opioids in particular can cause pupil dilation during withdrawal.

There are not many long-term studies of the effects of whether consistent drug use can cause permanent changes in pupils. More ongoing research will be able to give a clearer answer in the future.

Managing Your Pupil Dilation: Asking For Help

When your pupils are dilated as a result of drug use or any other reason, they can cause you discomfort. Remember: dilated pupils let in greater amounts of light. When you take in more light, normal light levels like an average sunny or semi-cloudy day can seem overwhelmingly bright to you.

You will probably be very sensitive to any light sources while your pupils are dilated. To help make yourself more comfortable, you can wear protective eye gear to help shield your eyes from light levels.

For example, many people use either photochromic lenses in their glasses or wear sunglasses. Photochromic lenses adjust to the light levels automatically, darkening and lightening in response to sunny or dark environments. Sunglasses, of course, help block glare from the sunlight and can keep your sensitive eyes well protected from the sun’s rays.

If you ever have any major concerns about abnormal pupil sizes, consult with an eye specialist to ensure you remain involved and aware about your health.

At Pathways Recovery, we understand that illicit substance use comes with many side effects and can heavily affect your life or your loved one’s life before you realize how severe everything has become. Our holistic and individualized treatment approach can help you turn your life around. Don’t delay your journey. Call us today at 916-735-8377 to get premier addiction treatment today.

Frequently Asked Questions


Which drugs make your pupils smaller?

Opioids generally make your pupils smaller. Smaller pupils are also known as “pinpoint pupils.” Commonly misused opioids include oxycodone, fentanyl, and heroin.

Can medication cause dilated pupils?

Yes, both prescription, over-the-counter, and illicit drugs can all cause dilated pupils. Drug interactions in the body often affect neurotransmitters in your brain. Neurotransmitters are chemical messengers in your body. The interactions and messages between neurotransmitters are key in operating your body’s central nervous system.

What drugs dilate and constrict pupils?

Drugs that can dilate pupils include: antihistamines, anticonvulsants, anticholinergics, antidepressants, benzodiazepines, decongestants, dopamine precursors, mydriatics, stimulants, selective serotonin reuptake inhibitors, amphetamines, bath salts, cocaine, crystal meth, ecstasy, and ketamine.

Drugs that constrict pupils include: oxycodone, fentanyl, morphine, codeine, and heroin.

Welcome To The Newly Redesigned Site – Stay Tuned For More Exciting News!

Newly Redesigned Addiction Treatment Site Pathways RecoveryAt Pathways Recovery, we are proud to announce the launch of our newly redesigned website. With our focus on providing high quality detox and outpatient addiction rehab treatment, we knew we needed a professional-looking, highly-functional website that provided up-to-date information and resources in an understandable and informative format. We believe that the new website has accomplished just that!

With informative content, an easy-to-navigate layout and the latest information on insurance and other important topics, our potential clients and their loved ones can find out what they need to know about addiction treatment at Pathways Recovery.

The website is organized by programs and detox services. There are also pages on nutrition and family education, as well as a blog that will include the latest information about addiction and recovery. The Admissions section provides valuable information such as cost, financing options, insurance information and more.

Pathways Recovery’s New Design And Logo

Along with the new website, Pathways Recovery also has a new look that includes an updated logo and design elements. The logo redesign represents an individual who has struggled with addiction now achieving new hope in recovery. New images of the facility have also been added to the website to give site visitors a visual perspective of the treatment offered at Pathways Recovery.

More Than Just An Updated Brand

While the new website and brand elements certainly improve the online presence of Pathways Recovery, they are also designed to provide quick, easy access to those who are facing the challenge of addiction. When confronted with such a seemingly insurmountable challenge, it only makes sense that the information provided should be given in a user-friendly, simple fashion.

What’s Next?

As we roll out this new website at the start of 2016, we are already looking at more exciting things to be launched this year. We encourage you to bookmark the Pathways Recovery site so that you can check back often as we launch new tools for helping those in need and their loved ones.

If you’re ready to overcome addiction or you know someone who is struggling with alcohol or drug abuse, we encourage you to check out our new site. There’s plenty of information about our facility and treatment options. Then, give us a call to speak to a caring and professional staff member.

SAMHSA Publishes Drug And Alcohol Treatment Program Completion Rates

Pathways-- SAMHSA Publishes Drug And Alcohol Treatment Program Completion Rates -- 08-23-16Drug And Alcohol Treatment Completion Rates

drug and alcohol treatment

SAMHSA Statistics

The most recent data available for completion rates at drug and alcohol treatment facilities shows some interesting results.  Assembled from 1.5 million discharges from facilities across 42 states, the report details overall completion rates as well as breaking the data down into a wide variety of criteria that can help to uncover more perspective on the experiences of people seeking drug and alcohol treatment in the United States.

Overall, the report found that the completion rate for people seeking drug and alcohol treatment was 47%.  Within this overall number, the data showed that completion rate varied widely depending upon factors such as substance of abuse and the type of service being offered by the drug and alcohol treatment facility.

Completion Rates for Addiction Treatment By Program

Pathways-- Detox Completion Stat -- 08-23-16The report shows that the completion rate for people seeking drug and alcohol treatment was highest for those discharged from residential treatment at 70% with completion rates at detoxification programs a close second at 67%.  For short term residential drug and alcohol treatment, the completion rate was 59%.  For longer term residential care the completion rate for people seeking drug and alcohol treatment declined to 44%.  With less structured outpatient drug and alcohol treatment the completion rate went even lower to 40%.  Completion rates for people seeking drug and alcohol treatment tended to be higher (66%) when alcohol was the primary cause for treatment, and when people were employed their completion rate at drug and alcohol treatment facilities tended to be higher.

The report is episodic based.  In other words if one person sought drug and alcohol treatment twice in the reported year their information would be treated as two separate discharges.  The report also gathered the reasons for people being discharged from drug and alcohol treatment other than completion.  After completion of the program, the next highest reason for people being discharged was voluntary separation.

SAMHSA’s support of drug and alcohol treatment professionals continues to be an important factor in improving the success rates of programs across the county.

Certainly comprehensive with a wide range of criteria including length of stay, substance of abuse, and others, drug and alcohol treatment professionals should be able to use the data to adjust their own programs to ensure a higher completion rate for their patients.

Are You An Enabler? | A Simple Questionnaire

Pathways-- Are You An Enabler -- 08-23-16To understand if you might possibly be enabling someone’s substance abuse and preventing them from seeking the addiction treatment they need, answer these questions with a “yes” or a “no”:

Are You An Enabler? : A Simple Questionnaire

  1. Do you call in sick for your loved one because they were too hung over to go to work or school?
  2. Have you ever told a lie to someone to cover up for your loved one’s substance abuse?
  3. Have you had to pay bills for your loved one that they were responsible for?
  4. Have you ever done someone else’s work for them because they failed  to complete it as a result of their substance abuse?
  5. Have you ever paid legal fees for your loved one or bailed him or her out of jail?
  6. Do you avoid talking you your loved one about their substance abuse because you are afraid of how they will react?
  7. Have you threatened to leave your loved one because of their substance abuse and then did not follow through on it?

Yes or No Addiciton Enabling SurveyIf you answered “yes” to any of these questions, then it is quite possible you are enabling someone’s substance abuse problem and standing in the way of them seeking the addiction treatment they need.  Addiction is a family disease and denial is a large part of it.  Denial of a substance abuse problem happens for both the addict and their loved ones when the issue is not confronted.

Enabling creates an environment in which an addict can comfortably continue to engage in negative and risky behavior without consequences.  “Helping” someone means we are doing something for someone who is incapable of doing it for themselves.  “Enabling” is doing something for someone when they should have done it for themselves.  This will prevent change and a desire to seek addiction treatment.

While enabling is a behavior that loved ones learn for their own emotional survival, it also prolongs the problem of substance abuse.  Don’t be part of the problem, be part of the solution and help your loved one seek out the addiction treatment they need.


Naltrexone Alcohol Drug Rehab Assisted Recovery in the Midwest

Pathways-- Naltrexone Alcohol Drug Rehab Assisted Recovery in the Midwest -- 08-23-16One of the latest tools in the fight against opiate dependence and addiction, Naltrexone is being used more and more throughout the Midwest to curb the problem of opiate abuse and dependence that is expanding nationally, and is now reaching the Western United States. This video is a great introduction to Naltrexone and the possibilities that it offers.

Naltrexone breaks the cycle of addiction and gives new hope for alcohol and opiate dependence.

Produced by ARCAmidwest.